Patients suffering from both obesity and hyperlipidemia are exposed to high risk of cardiovascular disease, as well as reducing body's white adipose tissue (WAT) could minimize risk of chronic cardiovascular disorders. Many weight-loss drugs have been reported to elevate the risk for cardiovascular diseases. Besides, statins, a class of cholesterol lowering drugs, have also been noticed to have mild to severe side effects. Therefore, researchers seek an alternative therapy to apply on anti-obesity and anti-hyperlipidemia.
During the progression of obesity, WAT mass expansion was thought to depend on both the adipocyte hyperplasia and hypertrophy. Thereby, adipocyte differentiation (from the preadipocytes into the adipocytes) was characterized as a major cellular process that positively associated with obesity. Two critical transcription factors, peroxisome proliferator-activated receptors (PPARs) and CCAAT/enhancer-binging proteins (C/EBPs), played the pivotal role to regulate the transcription activities of the genes associated with adipocyte differentiation. Increased C/EBP-β might produce PPAR-γ ligand to trigger PPAR-γ-mediated signaling pathways resulting in adipocyte differentiation and adipogenesis. Besides, 5′AMP-activated protein kinase (AMPK) can increase fatty acid oxidation by inhibit acetyl-CoA carboxylase (ACC) as well as reduce cholesterol synthesis by suppressing HMG-CoA reductase (HMGCR), respectively. Previous reports revealed that plasma level of adiponectin in the obese patients or mice is lower than lean subjects. Adiponectin, one of adipokines secreted by adipocytes, was able to promote adipocyte differentiation and to modulate energy metabolism by stimulate AMPK activation.
Some of plant ingredients within YSY prescription have been reported to exhibit the potential activities on anti-hyperlipidemic or anti-atherogenic effects (Aziz, Z, Wong, S. Y., & Chong, N. J. (2013). Effects of Hibiscus sabdariffa L. on serum lipids: a systematic review and meta-analysis. J Ethnopharmacol, 150, 442-450; Bisen, P. S., Baghel, R. K., Sanodiya, B. S., Thakur, G. S., & Prasad, G. B. (2010). Lentinus edodes: a macrofungus with pharmacological activities. Curr Med Chem, 17, 2419-2430; Fukushima, M., Ohashi, T., Fujiwara, Y., Sonoyama, K., & Nakano, M. (2001). Cholesterol-lowering effects of maitake (Grifola frondosa) fiber, shiitake (Lentinus edodes) fiber, and enokitake (Flammulina velutipes) fiber in rats. Exp Biol Med (Maywood), 226, 758-765; Tsi, D., Das, N. P., & Tan, B. K. (1995). Effects of aqueous celery (Apium graveolens) extract on lipid parameters of rats fed a high fat diet. Planta Med, 61, 18-21; Zeng, F., Zhao, C., Pang, J., Lin, Z, Huang, Y., & Liu, B. (2013). Chemical properties of a polysaccharide purified from solid-state fermentation of Auricularia auricular and its biological activity as a hypolipidemic agent. J Food Sci, 78, H1470-1475; Zhang, J., Liang, R., Wang, L, Yan, R., Hou, R., Gao, S., & Yang, B. (2013). Effects of an aqueous extract of Crataegus pinnatifida Bge. var. major N.E.Br. fruit on experimental atherosclerosis in rats. J Ethnopharmacol, 148, 563-569). Although single plant ingredient can provide inhibitory effects on hyperlipidemia, the multi-ingredient products might exhibit excellent synergistic activities.